Chibbaro Salvatore, Mirone Giuseppe, Makiese Orphée, George Bernard
Department of Neurosurgery, Hôpital Lariboisière, Paris, France.
J Neurosurg Spine. 2009 May;10(5):458-65. doi: 10.3171/2009.1.SPINE08186.
The multilevel oblique corpectomy (MOC) allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not require vertebral stabilization or fusion. In the present study, the authors' goal was to demonstrate the long-term efficacy and safety of MOC in the treatment of selected cases of spondylotic myelopathy.
The authors conducted a prospective study in a series of 268 patients who underwent MOC for cervical spondylotic myelopathy over a 14-year period. Preoperative and postoperative neurological functioning were evaluated with the modified Japanese Orthopaedic Association scale. Spinal stability was assessed in all patients on serial plain and dynamic cervical radiographs at the last follow-up. The degree of canal expansion after MOC was also measured using the spinal canal/vertebral body ratio, and directly by measuring the diameter of osseous canal on pre- and postoperative CT scans and high-resolution MR images.
At a mean follow-up of 96 months, clinical improvement was recorded in 86.6% of patients with a global recovery rate of 87.6%, clinical stability in 8%, and worsening in 5%. Long-term spinal stability was demonstrated in 98% of patients.
Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability.
多级斜行椎体切除术（MOC）可通过颈椎前外侧入路扩大椎管和椎间孔，同时可控制椎动脉，且无需椎体稳定或融合。在本研究中，作者的目标是证明MOC治疗特定颈椎病性脊髓病病例的长期疗效和安全性。
作者对268例在14年期间接受MOC治疗颈椎病性脊髓病的患者进行了一项前瞻性研究。采用改良日本骨科协会量表评估术前和术后神经功能。在最后一次随访时，对所有患者的颈椎X线平片和动态颈椎X线片进行脊柱稳定性评估。还使用椎管/椎体比率测量MOC术后的椎管扩张程度，并通过测量术前和术后CT扫描及高分辨率MR图像上的骨性椎管直径直接测量。
平均随访96个月时，86.6%的患者临床症状改善，总体恢复率为87.6%，8%的患者临床稳定，5%的患者病情恶化。98%的患者显示长期脊柱稳定性。
多级斜行椎体切除术被证明是一种安全的手术，在改善功能状态和长期脊柱稳定性方面取得了良好效果。
